| NPI | 1689814048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: NC 2015-00045) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY P60003(LTD PERMIT)) |
| 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: KS 04-34266) | |
| 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: FL ME125494) | |
| Enumeration Date | 2009-02-25 |
| Last Update Date | 2021-02-09 |