| NPI | 1760571764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: LA 200513) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA md200513) |
| 208000000X Pediatrics (Licence: LA md200513) | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2021-04-01 |