| NPI | 1033374079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX R7589) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301091694) |
| 208000000X Pediatrics (Licence: MO 2011020507) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TN MD0000051218) | |
| Enumeration Date | 2008-07-18 |
| Last Update Date | 2023-02-14 |