| NPI | 1780372417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: WI 87659-20) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 87659-20) |
| Enumeration Date | 2023-05-01 |
| Last Update Date | 2026-06-30 |