| NPI | 1063038990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX U6011) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX U6011) |
| Enumeration Date | 2020-06-16 |
| Last Update Date | 2024-06-25 |