| NPI | 1164925921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: CA A163781) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A163781) |
| 208M00000X Hospitalist (Licence: CA A163781) | |
| Enumeration Date | 2018-03-17 |
| Last Update Date | 2024-04-29 |