| NPI | 1336357029 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: VA 0101252547) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101252547) | 
| Enumeration Date | 2007-05-18 | 
| Last Update Date | 2024-03-22 |