| NPI | 1669560231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A43383) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A43383) |
| 207Q00000X Family Medicine (Licence: AZ 31704) | |
| 208000000X Pediatrics (Licence: AZ 31704) | |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: CA A43383) | |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: AZ 31704) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CA A43383) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: AZ 31704) | |
| 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: CA A43383) | |
| 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: AZ 31704) | |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: CA A43383) | |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: AZ 31704) | |
| 208M00000X Hospitalist (Licence: CA A43383) | |
| 208M00000X Hospitalist (Licence: AZ 31704) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2008-01-13 |