| NPI | 1720541568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 91356) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX T6408) |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2024-10-10 |