| NPI | 1083749998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: OH 35076200) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: IN 01050846) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: VA 0101276445) | |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2025-10-02 |