| NPI | 1306596135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 80386) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MN 80386) |
| Enumeration Date | 2022-03-25 |
| Last Update Date | 2025-08-20 |