| NPI | 1619310067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MD D86061) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MD D86061) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10045870) | |
| Enumeration Date | 2013-04-15 |
| Last Update Date | 2022-06-03 |