| NPI | 1215356795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AL MD.36966) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AL MD.36966) |
| Enumeration Date | 2014-04-10 |
| Last Update Date | 2021-02-05 |