| NPI | 1154383495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 35285) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 35285) |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2020-08-25 |