| NPI | 1811190408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2009008973) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MO 2009008973) |
| Enumeration Date | 2007-06-09 |
| Last Update Date | 2019-04-17 |