| NPI | 1689252355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CO DR.0072713) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX 48329) |
| Enumeration Date | 2021-04-01 |
| Last Update Date | 2025-08-08 |