| NPI | 1700040599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NM MD2015-0222) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35097005) |
| 208000000X Pediatrics (Licence: MO 2012012816) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: IN 01078297A) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: FL ME129316) | |
| Enumeration Date | 2008-07-11 |
| Last Update Date | 2020-02-20 |