| NPI | 1780024109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX U2273) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125062844) |
| 208000000X Pediatrics (Licence: MO 2016023348) | |
| Enumeration Date | 2013-06-29 |
| Last Update Date | 2023-12-19 |