| NPI | 1609864511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 200600478) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NC 200600478) |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2022-09-23 |