| NPI | 1790280055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083B0002X Preventive Medicine, Obesity Medicine (Licence: TX 89997134) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35141185) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 35141185) | |
| 208M00000X Hospitalist (Licence: OH 35141185) | |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2025-01-27 |