| NPI | 1528279171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TX N8163) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX N8163) |
| 208000000X Pediatrics (Licence: TX N8163) | |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2024-06-18 |