| NPI | 1104893866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101253359) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: VA 0101253359) |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2023-03-27 |