| NPI | 1154853851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MD D89366) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 1019279) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MA 1019279) | |
| Enumeration Date | 2017-03-31 |
| Last Update Date | 2024-06-26 |