NPI | 1265896658 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 77160) |
Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 35139444) |
208000000X Pediatrics (Licence: OH 35139444) | |
Enumeration Date | 2016-04-12 |
Last Update Date | 2025-09-17 |