| NPI | 1467914291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA 20A22063) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 94-10001) |
| 207R00000X Internal Medicine (Licence: MO 2019021760) | |
| 208000000X Pediatrics (Licence: MO 2019021760) | |
| 208000000X Pediatrics (Licence: KS 94-10001) | |
| 208M00000X Hospitalist (Licence: AZ 010652) | |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2023-11-03 |