| NPI | 1679749592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX P6833) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: DC MD038741) |
| Enumeration Date | 2008-04-30 |
| Last Update Date | 2025-11-18 |