| NPI | 1770586919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TN 11542) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN MD11542) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2016-12-16 |