| NPI | 1366825200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: WI 74146) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 275372) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MA 275372) | |
| Enumeration Date | 2015-07-08 |
| Last Update Date | 2021-12-20 |