| NPI | 1265651467 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2007010562)  | 
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MO 2007010562)  | 
| 208000000X Pediatrics (Licence: MO 2007010562)  | |
| Enumeration Date | 2007-04-25 | 
| Last Update Date | 2025-04-17 |