| NPI | 1477903607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OK 39544) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 86832) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MO 2019006476) | |
| 208M00000X Hospitalist (Licence: MO 2019006476) | |
| Enumeration Date | 2016-06-19 |
| Last Update Date | 2022-10-04 |