| NPI | 1083147391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: PA OS023018) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA OT017906) |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2023-08-17 |