| NPI | 1811170905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OR MD157527) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: UT 6805114-1205) |
| 207R00000X Internal Medicine (Licence: UT 6805114-1205) | |
| 207R00000X Internal Medicine (Licence: OR MD157527) | |
| Enumeration Date | 2007-12-11 |
| Last Update Date | 2013-12-06 |