| NPI | 1144457011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA 60303100) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WA 60303100) |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2018-06-09 |