| NPI | 1770643009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX N2364) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME 97074) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX N2364) | |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2023-12-03 |