| NPI | 1053585620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX P9418) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101243840) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: VA 0101243840) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: VA 0101243840) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CO DR0057057) | |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2017-01-20 |