| NPI | 1467706846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25MA11861300) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 57756) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: PA MD462417) | |
| 208M00000X Hospitalist (Licence: MN 57756) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: #39) | |
| Enumeration Date | 2012-11-06 |
| Last Update Date | 2023-11-29 |