| NPI | 1386965358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: PA MT198181) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX U8985) |
| 208M00000X Hospitalist (Licence: TX U8985) | |
| Enumeration Date | 2010-06-14 |
| Last Update Date | 2025-02-10 |