| NPI | 1023270238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MA 262506) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MA 262506) |
| 207L00000X Anesthesiology (Licence: MA 262506) | |
| 208000000X Pediatrics (Licence: MA 262506) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CA A116860) | |
| Enumeration Date | 2008-06-29 |
| Last Update Date | 2019-08-15 |