| NPI | 1508854563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AZ MD526810) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: AZ 50525) |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2022-01-31 |