| NPI | 1275649154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: GA 97784) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD073756L) |
| 208000000X Pediatrics (Licence: GA 97784) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: PA MD073756L) | |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2025-03-25 |