| NPI | 1972817807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2013021804) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2013021804) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MO 2013021804) | |
| Enumeration Date | 2010-08-03 |
| Last Update Date | 2024-04-25 |