| NPI | 1871080895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TX S9099) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX S9099) |
| 208000000X Pediatrics (Licence: TX BP10063707) | |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2024-02-07 |