| NPI | 1639435431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CO CDR.0000103) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NE 1719) |
| Enumeration Date | 2012-04-05 |
| Last Update Date | 2019-10-02 |