| NPI | 1568673556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 062934) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC 83699) |
| 207L00000X Anesthesiology (Licence: AL MD.29707) | |
| 208000000X Pediatrics (Licence: GA 062934) | |
| 208000000X Pediatrics (Licence: AL MD.2009) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: GA 062934) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: AL MD.29707) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2024-03-21 |