| NPI | 1033556618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: PA MT204393) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT204393) |
| Enumeration Date | 2013-05-23 |
| Last Update Date | 2020-03-18 |