| NPI | 1134164502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 9300458) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: ID M-16945) |
| 208M00000X Hospitalist (Licence: ND PT18845) | |
| 208M00000X Hospitalist (Licence: MN 66911) | |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2023-01-13 |