| NPI | 1376030569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: PA MD474876) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NY 335452) |
| 208000000X Pediatrics (Licence: UT 11405545-1205) | |
| Enumeration Date | 2018-04-13 |
| Last Update Date | 2025-11-24 |