| NPI | 1710070941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AL 32039) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 217088) |
| 208000000X Pediatrics (Licence: AL MD.32039) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2021-09-02 |