| NPI | 1316331341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AK 129285) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA ML.60562586) |
| 208000000X Pediatrics (Licence: AK 129285) | |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2019-01-30 |