| NPI | 1790970796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 55252) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 55252) |
| 208000000X Pediatrics (Licence: TX N8872) | |
| 208M00000X Hospitalist (Licence: TX n8872) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2021-08-18 |