| NPI | 1790070514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MA T288745) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: PA MD462181) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MA T288745) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: PA MD462181) | |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2021-07-05 |