| NPI | 1376925545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NY 311048) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT209804) |
| 208000000X Pediatrics (Licence: CT 61442) | |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2021-07-13 |