| NPI | 1992790760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 278455) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 67435) |
| 208000000X Pediatrics (Licence: FL ME107217) | |
| 208M00000X Hospitalist (Licence: TX R3029) | |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2022-09-01 |