| NPI | 1477949873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX R7172) |
| Additional Taxonomies | 207LH0002X Anesthesiology, Hospice and Palliative Medicine (Licence: TX R7172) |
| 2080H0002X (Licence: TX R7172) | |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2024-06-21 |