| NPI | 1063562924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: AR E-16817) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AR E-16817) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: OH 35-095132) | |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2023-08-28 |