| NPI | 1730481755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CA A114006) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A114006) |
| Enumeration Date | 2010-11-23 |
| Last Update Date | 2024-10-30 |