| NPI | 1225474158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: FL ME135289) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL TRN24124) |
| 208000000X Pediatrics (Licence: PA MT204391) | |
| Enumeration Date | 2013-05-19 |
| Last Update Date | 2021-08-13 |