| NPI | 1114008877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX J3861) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX J3861) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX J3861) | |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2025-09-11 |