| NPI | 1508061680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: CO DR.0050240) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO 50240) |
| 208000000X Pediatrics (Licence: CO 50240) | |
| 208M00000X Hospitalist (Licence: CO 50240) | |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2018-12-04 |