| NPI | 1073802591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: PA OS016578) |
| Additional Taxonomies | 208D00000X General Practice (Licence: DE C20010658) |
| 208D00000X General Practice (Licence: PA OS016578) | |
| 208M00000X Hospitalist (Licence: PA OSO16578) | |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2018-05-02 |