| NPI | 1467972687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MN 74172) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA 61030795) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2024-03-29 |