| NPI | 1497161046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: KY 04133) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 04133) |
| 208M00000X Hospitalist (Licence: KY 04133) | |
| Enumeration Date | 2014-07-03 |
| Last Update Date | 2019-01-17 |