| NPI | 1972829489 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036.133463) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35139524) | 
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 35139524) | |
| 208M00000X Hospitalist (Licence: OH 35139524) | |
| Enumeration Date | 2010-04-09 | 
| Last Update Date | 2023-06-01 |