| NPI | 1093090631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: IA MD-45097) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 53625) |
| 208000000X Pediatrics (Licence: MI 4301104482) | |
| Enumeration Date | 2011-10-14 |
| Last Update Date | 2023-11-06 |