| NPI | 1710128673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CO DR.0050813) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO 50813) |
| Enumeration Date | 2009-03-23 |
| Last Update Date | 2018-12-04 |