| NPI | 1134238777 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080H0002X Pediatrics, Hospice and Palliative Medicine (Licence: TX M5467)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX M5467)  | 
| 207P00000X Emergency Medicine (Licence: IA 37441)  | |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: TX M5467)  | |
| 208000000X Pediatrics (Licence: LA MD201010)  | |
| Enumeration Date | 2006-08-29 | 
| Last Update Date | 2023-05-01 |