| NPI | 1225370331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX r9462) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX R9264) |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2020-11-24 |