| NPI | 1245404656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2021048792) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: KS 35240) |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2021-12-16 |