| NPI | 1619336146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MA 279692) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 279692) |
| Enumeration Date | 2016-02-11 |
| Last Update Date | 2023-10-31 |