| NPI | 1326179672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX P0855) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101240638) |
| 208000000X Pediatrics (Licence: VA 0116016822) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: DC MD037342) | |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2011-12-14 |