| NPI | 1376997965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CO DR.0069920) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.136613) |
| Enumeration Date | 2016-04-20 |
| Last Update Date | 2025-01-14 |