| NPI | 1790877520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD424484) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: DE C10007366) |
| 208D00000X General Practice (Licence: DE C10007366) | |
| 208M00000X Hospitalist (Licence: PA MD424484) | |
| 208M00000X Hospitalist (Licence: DE C10007366) | |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2021-12-01 |