| NPI | 1609088350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CA 20A9172) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA 20A 9172) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2023-11-10 |