| NPI | 1770825044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CO DR.0058727) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 266318) |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2020-09-10 |