| NPI | 1881642999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: LA 202000) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: SD 5689) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NV 11778) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NC 200100466) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: LA 202000) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NC 200100466) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2022-08-10 |