| NPI | 1801325261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NY 306541) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT212912) |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2023-05-11 |