| NPI | 1679505341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD042258E) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD042258E) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: PA MD042258E) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2025-03-20 |