| NPI | 1740541176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 5101020015) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101020015) |
| 208M00000X Hospitalist (Licence: MI 5101020015) | |
| Enumeration Date | 2012-06-01 |
| Last Update Date | 2018-07-16 |