| NPI | 1295755577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX Q9138) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX Q9138) |
| 208000000X Pediatrics (Licence: KS 04-31771) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2019-01-09 |