| NPI | 1821352212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CA A136870) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A136870) |
| 208000000X Pediatrics (Licence: NC 2018-01154) | |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2025-12-08 |