| NPI | 1154825313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: UT 11415673-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 11415673-1205) |
| 208000000X Pediatrics (Licence: UT 11415673-1205) | |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2025-03-31 |