| NPI | 1679967780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 943311) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 34.012931) |
| 208M00000X Hospitalist (Licence: AZ 007957) | |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2023-04-07 |