| NPI | 1780194142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: UT 11924123-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: UT 11924123-1205) |
| Enumeration Date | 2017-10-11 |
| Last Update Date | 2022-10-20 |