| NPI | 1851822605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 73562) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CO DR.0064195) |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2023-08-03 |