| NPI | 1073967667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TX S0223) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX BP10055841) |
| 208000000X Pediatrics (Licence: TX S0223) | |
| Enumeration Date | 2016-04-20 |
| Last Update Date | 2023-09-25 |