| NPI | 1861451536 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: PR 11430) | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: PR 11430) | 
| Enumeration Date | 2006-03-21 | 
| Last Update Date | 2019-01-22 |