| NPI | 1104271535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TX R9402) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NM DO2022-0145) |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2026-08-11 |