| NPI | 1285051508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: TX R2201) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX R2201) |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2022-11-09 |