| NPI | 1720351935 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX U5278) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX U5278) |
| 208000000X Pediatrics (Licence: AZ 66063) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: AZ 66063) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MN 60401) | |
| Enumeration Date | 2012-02-18 |
| Last Update Date | 2024-09-09 |