| NPI | 1124054689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A84467) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CA A84467) |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2024-01-05 |