| NPI | 1215982889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NM MD2021-0925) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 200200957) |
| 208000000X Pediatrics (Licence: AZ 35241) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: AZ 35241) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: AZ 35241) | |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2021-10-15 |