| NPI | 1013301316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: PA MD478006) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 274306) |
| 208000000X Pediatrics (Licence: WA 60950335) | |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2022-07-04 |