| NPI | 1033558903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: FL ME157010) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 6266) |
| 208000000X Pediatrics (Licence: LA 334982) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: UT 9712506-8905) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: LA 334982) | |
| 208000000X Pediatrics (Licence: UT 9712506-1205) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: LA 334982) | |
| Enumeration Date | 2013-06-24 |
| Last Update Date | 2025-09-18 |