| NPI | 1124555057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: CA A158217) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CA A158217) |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2024-06-25 |