| NPI | 1962965012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 70091) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 70091) |
| 208000000X Pediatrics (Licence: AZ 70091) | |
| Enumeration Date | 2019-04-07 |
| Last Update Date | 2023-10-03 |