| NPI | 1568697233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2026035349) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.099866) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: KS 04-38041) | |
| Enumeration Date | 2009-05-22 |
| Last Update Date | 2026-08-11 |