| NPI | 1316145832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CA A92797) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 002881) |
| 208000000X Pediatrics (Licence: CA A92797) | |
| 208000000X Pediatrics (Licence: PA MD426037) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NY 002881) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: PA MD426037) | |
| 282NC2000X General Acute Care Hospital, Children (Licence: AZ 43740) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: AZ 43740) | |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2015-06-16 |