| NPI | 1053948331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA 20A20556) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA 20A20556) |
| 208000000X Pediatrics (Licence: UT 12403626-1204) | |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2024-04-28 |