| NPI | 1760743843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301100912) |
| Additional Taxonomies | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: MI 4301501340) |
| Enumeration Date | 2012-06-05 |
| Last Update Date | 2022-03-23 |