| NPI | 1811042799 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: ME MD19777) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 229873) | 
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: ND 13373) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MD D0077497) | |
| Enumeration Date | 2007-01-24 | 
| Last Update Date | 2025-01-23 |