| 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 |