| NPI | 1497430482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2026014304) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2026014304) |
| Enumeration Date | 2023-06-19 |
| Last Update Date | 2026-09-01 |