| NPI | 1104881200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MD D0053290) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: MD D0053290) |
| 208M00000X Hospitalist (Licence: MD D0053290) | |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2018-03-26 |