| NPI | 1811999360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101273960) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NC 9600463) |
| 207R00000X Internal Medicine (Licence: NC 9600463) | |
| 208000000X Pediatrics (Licence: NC 9600463) | |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2022-02-17 |