| NPI | 1558476291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 16604) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 16604) |
| 208000000X Pediatrics (Licence: WI 54324) | |
| 208000000X Pediatrics (Licence: IL 036136987) | |
| 208M00000X Hospitalist (Licence: IL 036136987) | |
| 208M00000X Hospitalist (Licence: WI 54324) | |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2021-08-18 |