| NPI | 1982686549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA C55390) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 152593) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CA C55390) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MA 152593) | |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2025-03-10 |