| NPI | 1508506726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: SC 87592) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: SC 87592) |
| Enumeration Date | 2022-03-29 |
| Last Update Date | 2026-02-23 |