| NPI | 1013159664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CO DR.0050426) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO DR.0050426) |
| 208000000X Pediatrics (Licence: CO DR.0050426) | |
| Enumeration Date | 2009-03-28 |
| Last Update Date | 2021-11-09 |