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Individual
WUI IP
Active
Individual
WUI IP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
A135606
CA
2083C0008X
Clinical Informatics Physician
A135606
CA
208M00000X
Hospitalist Physician
Primary
A135606
CA
Other
Enumeration date
05/23/2013
Last updated
04/28/2024
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