NPI | 1639800022 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: WI 81935-21) |
Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125.081243) |
208000000X Pediatrics (Licence: PA OT022077) | |
208M00000X Hospitalist (Licence: WI 81935-21) | |
Enumeration Date | 2022-06-17 |
Last Update Date | 2025-07-18 |