| NPI | 1235593112 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WV 3871) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MI 5101025113) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: WV 3871) | |
| Enumeration Date | 2016-04-07 |
| Last Update Date | 2026-02-24 |