| NPI | 1295354538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME163400) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: FL ME163400) |
| 208000000X Pediatrics (Licence: TN 72439) | |
| Enumeration Date | 2020-04-15 |
| Last Update Date | 2026-06-18 |