| NPI | 1710544408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MI 4301511888) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2022018307) |
| 208M00000X Hospitalist (Licence: MO 2022018307) | |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2024-07-12 |