| NPI | 1376030569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: PA MD474876) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: UT 11405545-1205) |
| Enumeration Date | 2018-04-13 |
| Last Update Date | 2024-07-22 |