| NPI | 1053607705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MT041849T) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: PA MD470084) |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2020-04-27 |