| NPI | 1730749110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX V7575) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2021004962) |
| 208M00000X Hospitalist (Licence: MO 2021004962) | |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2025-06-19 |