| NPI | 1386964062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX Q1710) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: ID MC-2916) |
| 208000000X Pediatrics (Licence: LA MD.205315) | |
| 208000000X Pediatrics (Licence: MN 62411) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX Q1710) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MN 62411) | |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2024-06-14 |