| NPI | 1952788747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101281752) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301107864) |
| 208M00000X Hospitalist (Licence: IL 036155855) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-30 |
| Last Update Date | 2024-08-14 |