| NPI | 1821036385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX Q7957) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NV 11672) |
| 208D00000X General Practice (Licence: NV 11672) | |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2023-01-10 |