| NPI | 1134487036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX BP1-0042812) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX BP1-0042812) |
| 208000000X Pediatrics (Licence: NE 28551) | |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2025-09-12 |