| NPI | 1346552072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: VA 0101263728) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101263728) |
| Enumeration Date | 2010-07-10 |
| Last Update Date | 2026-07-20 |