NPI | 1992854830 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208M00000X Hospitalist (Licence: TX N2716) |
Additional Taxonomies | 208000000X Pediatrics (Licence: TX N2716) |
2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TX N2716) | |
Enumeration Date | 2007-01-09 |
Last Update Date | 2018-10-15 |