| NPI | 1679899116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: ND 13348) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 57027) |
| 208M00000X Hospitalist (Licence: WI 57027) | |
| Enumeration Date | 2010-04-08 |
| Last Update Date | 2022-03-25 |