| NPI | 1497098354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA ML60368641) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA ML60368641) |
| Enumeration Date | 2013-03-29 |
| Last Update Date | 2020-05-18 |