| NPI | 1780115980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CO 0063947) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208000000X Pediatrics (Licence: CO 0063947) | |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2022-05-27 |