| 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) |
| Enumeration Date | 2011-09-28 |
| Last Update Date | 2022-12-05 |