| NPI | 1790890556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 69662) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 69662) |
| 208000000X Pediatrics (Licence: IL 036138482) | |
| 208M00000X Hospitalist (Licence: IL 036138482) | |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2018-10-23 |