| NPI | 1023100930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AZ 77621) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2005-01394) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NC 2005-01394) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: AZ 77621) | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2025-12-03 |