| NPI | 1104557719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A176948) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A176948) |
| Enumeration Date | 2022-06-23 |
| Last Update Date | 2024-11-14 |