| NPI | 1568641306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME159673) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AR E11708) |
| 208000000X Pediatrics (Licence: WA md00048960) | |
| Enumeration Date | 2007-10-29 |
| Last Update Date | 2023-02-23 |