| NPI | 1629462569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CO DR.0060161) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 0145808) |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2020-06-15 |