| NPI | 1992191860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CO DR.0067611) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 69497-20) |
| 208000000X Pediatrics (Licence: CO DR.0067611) | |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2022-05-02 |