| NPI | 1811316276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2017022852) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2017022852) |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2024-04-25 |