| NPI | 1720532021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD464178) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: VA 0101281063) |
| 208000000X Pediatrics (Licence: IL 125066980) | |
| Enumeration Date | 2016-08-04 |
| Last Update Date | 2024-11-25 |