| NPI | 1376538108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NY 170455-1) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: AZ 79841) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: VA 0101278514) | |
| Enumeration Date | 2005-09-19 |
| Last Update Date | 2026-07-01 |