| NPI | 1013967744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: FL ME69224) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA MD.11348R) |
| 208000000X Pediatrics (Licence: FL ME0069224) | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2021-03-29 |