| NPI | 1477789675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 50469) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 01072707) |
| 208000000X Pediatrics (Licence: OH 35.121509) | |
| Enumeration Date | 2009-06-02 |
| Last Update Date | 2018-03-17 |