| NPI | 1578599205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TX k5812) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX K5812) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX k5812) | |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2023-10-24 |