| NPI | 1124306113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 60294-20) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WI 60294-20) |
| Enumeration Date | 2011-07-26 |
| Last Update Date | 2021-12-09 |