| NPI | 1013560473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: ND 19012) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4351044284) |
| Enumeration Date | 2019-07-24 |
| Last Update Date | 2023-01-05 |