| NPI | 1528563772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 89503) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 56427) |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2023-08-21 |