| NPI | 1497487573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2025026346) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MO 2025026346) |
| Enumeration Date | 2022-06-28 |
| Last Update Date | 2026-04-03 |