| NPI | 1114923984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: TX K2637) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TX K2637) |
| 208000000X Pediatrics (Licence: TX K2637) | |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2013-08-02 |