| NPI | 1871617621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CA C155479) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA C155479) |
| 208000000X Pediatrics (Licence: MI 4301084799) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MI 4301084799) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MI 4301084799) | |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2024-04-11 |