| NPI | 1629606306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KY 58146) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 58146) |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2025-10-23 |