| NPI | 1215959515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036105873) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036105873) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: IL 036105873) | |
| 208000000X Pediatrics (Licence: WI 45376-20) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2026-07-20 |