| NPI | 1467710921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME136517) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN MD52838) |
| 208M00000X Hospitalist (Licence: TN MD52838) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-05-02 |
| Last Update Date | 2021-03-23 |