| NPI | 1891809240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: WA MD00047905) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NV 13176) |
| 207L00000X Anesthesiology (Licence: WA MD00047905) | |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2011-06-08 |