| NPI | 1588005714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: IA MD-48083) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX V5489) |
| Enumeration Date | 2013-07-16 |
| Last Update Date | 2025-01-23 |