| NPI | 1477698892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: DE C10007997) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: DE C10007997) |
| 208000000X Pediatrics (Licence: PA MD 434313) | |
| 208M00000X Hospitalist (Licence: PA MD434313) | |
| 208D00000X General Practice (Licence: DE C10007997) | |
| 208D00000X General Practice (Licence: PA MD 434313) | |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2011-12-27 |