| NPI | 1578574430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX G6861) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX G6861) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2018-10-11 |