| 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: MA 234619) |
| 208000000X Pediatrics (Licence: FL ME110130) | |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2021-03-09 |