| NPI | 1821185372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD464512) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101260078) |
| 208000000X Pediatrics (Licence: MD D71001) | |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MD D71001) | |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: VA 0101260078) | |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2025-03-25 |