| NPI | 1720334493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: FL ME161982) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX S1704) |
| 208000000X Pediatrics (Licence: TX S1704) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX S1704) | |
| Enumeration Date | 2012-07-31 |
| Last Update Date | 2024-04-10 |