| NPI | 1669756409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: FL ME120017) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME120017) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: FL ME120017) | |
| Enumeration Date | 2011-09-28 |
| Last Update Date | 2024-11-17 |