| NPI | 1811315310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AR E-10525) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: AR E-10525) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 208000000X Pediatrics (Licence: AR E10525) | |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2018-03-22 |