| NPI | 1700317500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080H0002X (Licence: TX V2082) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX v2082) |
| 208000000X Pediatrics (Licence: TX V2082) | |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2024-07-02 |