| NPI | 1396131819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX W0425) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MD D0104428) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NV 19105) | |
| 208000000X Pediatrics (Licence: TX W0425) | |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2025-12-18 |