| NPI | 1487868311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: ID M-12472) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: ID M-12472) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2020-08-26 |