| NPI | 1083783500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX K4565) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: TX K4565) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2022-08-16 |