| NPI | 1568812402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: ID O-1664) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ SH3107) |
| 208000000X Pediatrics (Licence: MI 5101022709) | |
| 208000000X Pediatrics (Licence: ID O-1664) | |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2022-07-07 |