| NPI | 1790726412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NE 29550) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX L8290) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TX L8290) | |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: UT 68789661205) | |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2021-11-11 |