| NPI | 1538576681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2018-01177) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301105700) |
| Enumeration Date | 2014-07-21 |
| Last Update Date | 2025-03-27 |