| NPI | 1174725253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: TX P9165) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX P9165) |
| 208000000X Pediatrics (Licence: FL ME 101777) | |
| 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: FL ME 101777) | |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2021-09-24 |