| NPI | 1154859163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MT212773) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD470339) |
| 208000000X Pediatrics (Licence: MA 291807) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MA 291807) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: PA MD470339) | |
| Enumeration Date | 2017-06-03 |
| Last Update Date | 2023-06-16 |