| NPI | 1902570724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VT 042.0017988) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NY 332818) |
| 208M00000X Hospitalist (Licence: VT 042.0017988) | |
| 208000000X Pediatrics (Licence: NY 332818) | |
| Enumeration Date | 2021-08-04 |
| Last Update Date | 2025-09-19 |