| NPI | 1528352812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: RI MD18881) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 257254) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: FL ME136330) | |
| Enumeration Date | 2011-06-03 |
| Last Update Date | 2022-11-25 |