| NPI | 1265539969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: AZ 55840) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX L5417) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX L5417) | |
| Enumeration Date | 2006-09-17 |
| Last Update Date | 2018-07-25 |