| NPI | 1538698154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX U9959) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 009031) |
| Enumeration Date | 2017-06-07 |
| Last Update Date | 2024-12-23 |