| NPI | 1598129009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: VA 0101275517) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 218106) |
| 208000000X Pediatrics (Licence: AZ 58038) | |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2022-06-09 |