| NPI | 1528592854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A21317) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MI 5101025633) |
| Enumeration Date | 2017-04-13 |
| Last Update Date | 2025-11-17 |