| NPI | 1730686460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX BP10063608) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX T1910) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TX T1910) | |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2023-06-26 |