| NPI | 1902046253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX V4691) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NM MD2012-0245) |
| 208000000X Pediatrics (Licence: NM MD2012-0245) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NM MD20120245) | |
| Enumeration Date | 2009-02-26 |
| Last Update Date | 2025-01-02 |