| NPI | 1033591938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX R5528) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2015014319) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX R5528) | |
| Enumeration Date | 2015-06-26 |
| Last Update Date | 2026-06-24 |