| NPI | 1003566795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CO DR.0075523) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO DR.0075523) |
| Enumeration Date | 2022-03-25 |
| Last Update Date | 2025-08-14 |