| NPI | 1992230767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: UT 12256630-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 70979) |
| 208M00000X Hospitalist (Licence: WI 70979) | |
| Enumeration Date | 2017-04-28 |
| Last Update Date | 2021-05-27 |