| NPI | 1104117522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301113345) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME138517) |
| 208000000X Pediatrics (Licence: IA MD-41687) | |
| 208000000X Pediatrics (Licence: TX T9559) | |
| 208M00000X Hospitalist (Licence: IA MD-41687) | |
| 208M00000X Hospitalist (Licence: TX T9559) | |
| Enumeration Date | 2011-04-20 |
| Last Update Date | 2023-06-21 |