| NPI | 1538484514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CO DR.0064105) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO DR.0064105) |
| 208000000X Pediatrics (Licence: CO DR.0064105) | |
| 208000000X Pediatrics (Licence: OH 35.131932) | |
| 208M00000X Hospitalist (Licence: OH 35.131932) | |
| Enumeration Date | 2010-04-01 |
| Last Update Date | 2025-05-29 |