| NPI | 1417101882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: UT 7152180-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD61269012) |
| 208000000X Pediatrics (Licence: UT 7152180-1205) | |
| Enumeration Date | 2008-11-11 |
| Last Update Date | 2024-09-16 |