| NPI | 1689068116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IA MD-47472) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 293283) |
| 208000000X Pediatrics (Licence: IA MD-47472) | |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2023-09-25 |