| NPI | 1104917475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: DE C10006653) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: DE C10006653) |
| 208M00000X Hospitalist (Licence: PA MD060503L) | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2011-12-28 |