| NPI | 1225200116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: FL ME110130) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME110130) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: LA 347382) | |
| 208000000X Pediatrics (Licence: MA 234619) | |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2026-06-01 |