| NPI | 1275951451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 79445) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: UT 10356676-1205) |
| 208000000X Pediatrics (Licence: WI 65165-20) | |
| 208M00000X Hospitalist (Licence: UT 10356676-1205) | |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2025-08-04 |