| NPI | 1891729091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX E6960) |
| Additional Taxonomies | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: TX E6960) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2018-05-22 |