| NPI | 1174049282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CT 70851) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: VA 0109542097) |
| Enumeration Date | 2017-08-21 |
| Last Update Date | 2022-06-07 |