| NPI | 1841510112 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NC 2013-00978) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2013-00978) |
| 207P00000X Emergency Medicine (Licence: NC 2013-00978) | |
| 208000000X Pediatrics (Licence: NC 2013-00978) | |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2024-03-11 |