| NPI | 1457641771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX P2771) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX BP10034399) |
| Enumeration Date | 2011-04-08 |
| Last Update Date | 2016-02-25 |