| NPI | 1457518128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NY 232430) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 232430) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MN 104906) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MT MED-PHYS-LIC-98755) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NJ 25MA11227100) | |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2024-03-04 |