| NPI | 1528697521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA 61611827) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: AZ 70278) |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2025-02-10 |