| NPI | 1275517179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: KY 38590) |
| Additional Taxonomies | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: KY 38590) |
| 208000000X Pediatrics (Licence: KY 38590) | |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2020-10-12 |