| NPI | 1568801363 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: AL MD.35815) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL MD.35815) |
| 208000000X Pediatrics (Licence: AL MD.35815) | |
| Enumeration Date | 2013-06-14 |
| Last Update Date | 2020-10-13 |