| NPI | 1275974693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX U5015) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NV 19969) |
| 208000000X Pediatrics (Licence: NV 19969) | |
| Enumeration Date | 2013-07-14 |
| Last Update Date | 2023-09-12 |