| NPI | 1508326596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: AL 46159) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AL 46159) |
| 208000000X Pediatrics (Licence: LA 330971) | |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2026-06-01 |