| NPI | 1114668308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A190596) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: UT 14279390-1205) |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2026-07-14 |