| NPI | 1366705675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MT201048) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: DC MD047426) |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2021-06-08 |