| NPI | 1659423713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 242126) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NV 15491) |
| 208000000X Pediatrics (Licence: HI MD-14446) | |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2019-11-07 |