| NPI | 1013996362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2007-01639) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2007-01639) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NC 2007-01639) | |
| Enumeration Date | 2006-01-14 |
| Last Update Date | 2024-04-22 |