| NPI | 1316470271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY 04800) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY TP280) |
| 208000000X Pediatrics (Licence: KY R4411) | |
| 208M00000X Hospitalist (Licence: KY TP280) | |
| 208M00000X Hospitalist (Licence: KY 04800) | |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2022-11-11 |