| 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 |