| NPI | 1124290960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX M9691) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX TEMPET) |
| Enumeration Date | 2008-04-01 |
| Last Update Date | 2021-04-09 |