| NPI | 1295028397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: SC 36766) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC 36766) |
| 208000000X Pediatrics (Licence: MN 390200000X) | |
| Enumeration Date | 2011-05-23 |
| Last Update Date | 2024-09-03 |