| NPI | 1992141006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2017-01209) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2017-01209) |
| 208000000X Pediatrics (Licence: NC 2017-01209) | |
| Enumeration Date | 2013-05-15 |
| Last Update Date | 2022-09-19 |