| NPI | 1932469962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: SC 82359) |
| Additional Taxonomies | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: NC 2018-01396) |
| 208000000X Pediatrics (Licence: TN 53024) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NC 2018-01396) | |
| Enumeration Date | 2012-05-24 |
| Last Update Date | 2019-07-03 |