| NPI | 1598720658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX K9832) |
| Additional Taxonomies | 2080P0214X Pediatrics Pediatric Pulmonology (Licence: TX K9832) |
| 146N00000X Emergency Medical Technician, Basic (Licence: TX K9832) | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2017-02-07 |