| NPI | 1649413824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: GA 95129) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TN 0000048757) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX Q6186) | |
| Enumeration Date | 2009-04-17 |
| Last Update Date | 2025-02-26 |