| NPI | 1891743019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WY 13829A) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NV 11710) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NC 200101336) | |
| 208M00000X Hospitalist (Licence: SD 9646) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: SD 9646) | |
| 207R00000X Internal Medicine (Licence: SD 9646) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2025-11-13 |