| NPI | 1104908094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CA A62461) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A62461) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: CA A62461) | |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2022-02-02 |