| NPI | 1972584043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01056095A) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IN 01056095A) |
| 2080A0000X Pediatrics, Adolescent Medicine (Licence: IN 01056095A) | |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2020-10-20 |