| NPI | 1952389686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX N4853) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NV 11509) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CA A90766) | |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2023-03-07 |