| NPI | 1356757017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NY 290056) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125-064928) |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2021-08-02 |