| NPI | 1578500617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: VA 0101057171) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101057171) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: VA 0101057171) | |
| 207L00000X Anesthesiology (Licence: VA 0101057171) | |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2020-04-25 |