| NPI | 1033185368 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NC 2013-00290)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2013-00290)  | 
| 207R00000X Internal Medicine (Licence: NC 2013-00290)  | |
| 208000000X Pediatrics (Licence: GA 050231)  | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: AL 37059)  | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: GA 050231)  | |
| Enumeration Date | 2006-02-27 | 
| Last Update Date | 2025-06-04 |