| NPI | 1215321419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2019-02861) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO DR.0060280) |
| 208M00000X Hospitalist (Licence: CO DR.0060280) | |
| Enumeration Date | 2015-03-25 |
| Last Update Date | 2021-03-29 |