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 |