| NPI | 1720340086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 297783) |
| Additional Taxonomies | 208D00000X General Practice (Licence: HI 17445) |
| 208M00000X Hospitalist (Licence: NY 297783) | |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2019-07-23 |