| NPI | 1023228772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MN 55666) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: OH 35.143797) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2023-01-06 |