| NPI | 1750540381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME124822) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA L-235943) |
| 208000000X Pediatrics (Licence: DC MD039463) | |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2015-09-17 |