| NPI | 1477884922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CA 20A12208) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ R1706) |
| Enumeration Date | 2010-01-22 |
| Last Update Date | 2020-06-30 |