| NPI | 1427623073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: PA MD484818) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT222384) |
| Enumeration Date | 2021-05-26 |
| Last Update Date | 2024-07-15 |