NPI | 1265896682 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208M00000X Hospitalist (Licence: TX U9452) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MI 5101024572) |
208000000X Pediatrics (Licence: IL 1265896682) | |
Enumeration Date | 2016-04-12 |
Last Update Date | 2024-05-30 |