| NPI | 1962026849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2023-01248) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2023-01248) |
| Enumeration Date | 2020-06-05 |
| Last Update Date | 2024-07-15 |