| NPI | 1851505069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: UT 8598708-1204) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA AC1220007) |
| 208M00000X Hospitalist (Licence: UT 8598708-1204) | |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2024-12-12 |