| NPI | 1801215611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 65485) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 65485) |
| 208000000X Pediatrics (Licence: MI 4301114303) | |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2025-09-11 |