| NPI | 1760435747 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 38165) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX K2529) | 
| 208M00000X Hospitalist (Licence: WI 38165) | |
| Enumeration Date | 2006-05-18 | 
| Last Update Date | 2014-10-16 |