| NPI | 1093131302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX R5589) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX R5589) |
| Enumeration Date | 2014-03-11 |
| Last Update Date | 2018-01-31 |