| NPI | 1568551042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY 31840) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: KY 31840) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2023-03-07 |