| NPI | 1396156857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX R3654) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX R3654) |
| Enumeration Date | 2014-05-17 |
| Last Update Date | 2022-08-08 |