| NPI | 1548460504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NM MD2019-0698) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MT 59214) |
| 208000000X Pediatrics (Licence: CO 48502) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CO 48502) | |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2024-03-04 |