| NPI | 1699161778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: KS 04-44868) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MO 2023029204) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: OK 31444) | |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2024-05-21 |