| NPI | 1396130621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CO 62482) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO 62482) |
| 208000000X Pediatrics (Licence: OR MD187610) | |
| Enumeration Date | 2015-04-03 |
| Last Update Date | 2019-07-12 |