| NPI | 1669553178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX Q8778) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX Q8778) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: FL TRN8815) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: FL ME99117) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TX Q8778) | |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2023-10-14 |