| NPI | 1174919575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2021009977) |
| Additional Taxonomies | 207PP0204X Emergency Medicine Pediatric Emergency Medicine (Licence: MO 2021009977) |
| 208000000X Pediatrics (Licence: MO 2021009977) | |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2024-04-25 |