| NPI | 1568955730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: IA MD-54875) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301114963) |
| 208000000X Pediatrics (Licence: IA MD-54875) | |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2025-08-13 |