NPI | 1972586006 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: AZ 47682) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MS 18975) |
208M00000X Hospitalist (Licence: MS 18975) | |
Enumeration Date | 2005-11-22 |
Last Update Date | 2013-08-01 |