| NPI | 1013170554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: HI b051459) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: HI DOS-1459) |
| 208M00000X Hospitalist (Licence: AZ 007238) | |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2025-12-15 |