| NPI | 1851684955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX R1149) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 261784) |
| 208000000X Pediatrics (Licence: TX R1149) | |
| 208000000X Pediatrics (Licence: MA 261784) | |
| Enumeration Date | 2011-05-23 |
| Last Update Date | 2025-05-10 |