| NPI | 1639142086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: PA MD434817) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD434817) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: AZ 10695) | |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2023-06-01 |