| NPI | 1467985200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: UT 13906379-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 69104) |
| Enumeration Date | 2017-04-08 |
| Last Update Date | 2024-05-09 |