| NPI | 1639110638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX M9577) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: WI 49276-020) |
| 208000000X Pediatrics (Licence: LA 022738) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: KS O4-30600) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: GA 046470) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: LA 022738) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MO 2004025527) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TN 40058) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: PA 435456) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: OH 35.083485) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: IN 01057110A) | |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2015-06-08 |