| NPI | 1164764486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX Q9448) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX Q9448) |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2023-05-03 |