| NPI | 1932769296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2021037208) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2021037208) |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2024-04-25 |