| NPI | 1760716591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NE 29118) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: AZ 45838) |
| 208000000X Pediatrics (Licence: AZ 45838) | |
| 208000000X Pediatrics (Licence: AZ R71577) | |
| 208000000X Pediatrics (Licence: WA MD60356718) | |
| Enumeration Date | 2009-09-26 |
| Last Update Date | 2016-04-15 |