| NPI | 1891771416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX L5542) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX L5542) |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2020-03-16 |