| NPI | 1720251382 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA ot012428)  | 
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NC 2012-00511)  | 
| 208M00000X Hospitalist (Licence: PA OS015510)  | |
| Enumeration Date | 2008-04-03 | 
| Last Update Date | 2021-02-19 |