| NPI | 1922595180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: UT 13355184-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301504283) |
| Enumeration Date | 2018-04-13 |
| Last Update Date | 2024-01-23 |