| NPI | 1891052825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX R7266) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 54230) |
| 2080S0012X Pediatrics, Sleep Medicine (Licence: TX R7266) | |
| Enumeration Date | 2012-04-16 |
| Last Update Date | 2020-07-29 |