| NPI | 1245654458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: UT 11710579-1204) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 01022049299) |
| Enumeration Date | 2014-02-07 |
| Last Update Date | 2023-08-03 |