| NPI | 1225154628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: WA MD60580688) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NV 13957) |
| 208000000X Pediatrics (Licence: CA A103590) | |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2023-03-07 |