| NPI | 1568495067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NC 9300610) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 9300610) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2024-07-15 |