| NPI | 1922279801 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 60832) | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WI 60832) | 
| Enumeration Date | 2008-03-18 | 
| Last Update Date | 2021-01-11 |