| NPI | 1104073550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A102897) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX P3189) |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2023-06-02 |