| NPI | 1447505375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: TX S2687) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2012018837) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2022-11-08 |