| NPI | 1316117153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME122680) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: IN 01068704) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: IN 01068704) | |
| Enumeration Date | 2008-03-07 |
| Last Update Date | 2025-04-24 |