| NPI | 1386650554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MI 4301086612) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301086612) |
| 208000000X Pediatrics (Licence: MI 4301086612) | |
| 2080H0002X (Licence: MI 4301086612) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2020-01-15 |