| NPI | 1891958104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: UT 12855169-1204) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: UT 12855169-1204) |
| 208000000X Pediatrics (Licence: OK 5072) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OK 5072) | |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2026-01-08 |