| NPI | 1184801755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: GA 000980) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 000980) |
| Enumeration Date | 2008-01-25 |
| Last Update Date | 2024-06-25 |