| NPI | 1639256571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KY 54959) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A76257) |
| 208M00000X Hospitalist (Licence: KY TP839) | |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2021-04-20 |