| NPI | 1851584270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: OH 35.135667) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TN 35394) |
| 208000000X Pediatrics (Licence: TN 35394) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NM MD2014-0091) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MO 2022038138) | |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2022-10-03 |