| NPI | 1457551921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX q5886) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT188960) |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2021-07-08 |