| NPI | 1124037692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 201501886) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: FL ME91053) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NC 201501886) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NC 2015-01886) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: FL 70934) | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2018-08-07 |