| NPI | 1407086333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX P2982) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: TX P2982) |
| Enumeration Date | 2009-07-27 |
| Last Update Date | 2024-07-01 |