| NPI | 1891743019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: SD 9646) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SD 9646) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NV 11710) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NC 200101336) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2021-08-30 |