| NPI | 1659831139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080H0002X Pediatrics, Hospice and Palliative Medicine (Licence: MA 1022192) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA11471000) |
| 208000000X Pediatrics (Licence: MA 1022192) | |
| 2080H0002X Pediatrics, Hospice and Palliative Medicine (Licence: DE C1-0026873) | |
| 208M00000X Hospitalist (Licence: NJ 25MA11471000) | |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2025-07-25 |