| NPI | 1962697250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036120153) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IL 036120153) |
| 208000000X Pediatrics (Licence: NC 2014-00844) | |
| 208000000X Pediatrics (Licence: NJ 25MA08308100) | |
| 208M00000X Hospitalist (Licence: IN 01064107A) | |
| 208000000X Pediatrics (Licence: IN 01064107A) | |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2025-09-24 |