| NPI | 1851505069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: UT 8598708-1204) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA AC1220007) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2024-09-19 |