NPI | 1265850440 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301500780) |
Additional Taxonomies | 208M00000X Hospitalist (Licence: CA 145445) |
Enumeration Date | 2014-04-03 |
Last Update Date | 2022-07-14 |