| NPI | 1548381916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: VA 0101258609) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101258609) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2020-10-13 |