| NPI | 1235182536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: FL ME150910) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD065944L) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: DE C10006597) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2026-08-17 |