| NPI | 1629079504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OR MD171590) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MT 10519) |
| 208000000X Pediatrics (Licence: TX M4333) | |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2015-06-26 |