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 |