| NPI | 1619436706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CO DR.0068130) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO TL.0007716) |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2025-06-25 |