| NPI | 1306229257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX T4340) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 274133) |
| Enumeration Date | 2015-07-09 |
| Last Update Date | 2022-09-21 |