| NPI | 1619949765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MI 4301079700) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301079700) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MI 4301079700) | |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2021-03-17 |