| NPI | 1720361744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: AL 37009) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AL 37009) |
| Enumeration Date | 2011-09-26 |
| Last Update Date | 2019-03-27 |