| NPI | 1598056814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WV 28150) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD451868) |
| Enumeration Date | 2011-04-20 |
| Last Update Date | 2022-04-06 |