| NPI | 1730567819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: UT 11701709-1204) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: UT 11701709-1204) |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2022-06-22 |