| NPI | 1184801714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: GA 067910) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: GA 067910) |
| 208000000X Pediatrics (Licence: GA 067910) | |
| 2080H0002X (Licence: GA 067910) | |
| Enumeration Date | 2008-01-25 |
| Last Update Date | 2021-03-30 |