| NPI | 1568536183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: SD 7216) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A74673) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2021-12-03 |