| NPI | 1235290693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: SC 33116) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC 33116) |
| 208000000X Pediatrics (Licence: TX L8471) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CO 45451) | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2018-03-23 |