| NPI | 1316309701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: TX U5222) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX U5222) |
| 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: CO DR.0062347) | |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2023-10-31 |