| NPI | 1154944585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 012495) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 012495) |
| Enumeration Date | 2020-05-20 |
| Last Update Date | 2026-07-29 |