| NPI | 1043625098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MI 4301105556) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301105556) |
| Enumeration Date | 2014-06-29 |
| Last Update Date | 2020-07-07 |