| NPI | 1164082913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MA 1023927) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MN 71264) |
| 208000000X Pediatrics (Licence: MN 71264) | |
| Enumeration Date | 2019-06-14 |
| Last Update Date | 2025-10-29 |