| NPI | 1235659434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CT 67508) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 271764) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2021-07-07 |