| NPI | 1912070632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: FL ME0091943) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: OK 21907) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX R1383) | |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2022-09-26 |