| NPI | 1942659933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX S2689) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX 1234567) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2025-01-16 |