| NPI | 1053607689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX R2022) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OR MD213963) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: VA 0101276314) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: WI 62187-020) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: IA 39586) | |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2024-02-08 |