| NPI | 1861711632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: OH 128472) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: WI 56372) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX V5409) | |
| 208000000X Pediatrics (Licence: TX V5409) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: IL 036-168860) | |
| Enumeration Date | 2010-05-19 |
| Last Update Date | 2026-02-23 |