| NPI | 1417488099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: UT 10957077-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: UT 10957077-1205) |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2021-11-03 |