| NPI | 1316919954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MD D0093739) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX K9622) |
| 207R00000X Internal Medicine (Licence: TX K9622) | |
| 208000000X Pediatrics (Licence: TX K9622) | |
| 208000000X Pediatrics (Licence: PA MD472766) | |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2022-04-26 |