| NPI | 1144278136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: OH 35073694) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301054627) |
| 208000000X Pediatrics (Licence: MA 224063) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MI 4301054627) | |
| 208000000X Pediatrics (Licence: OH 35073694) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MA 224063) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2022-09-16 |