| NPI | 1174747885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301081766) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301081766) |
| 208M00000X Hospitalist (Licence: MI 4301081766) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301081766) | |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2008-09-26 |