| NPI | 1831317395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TN 49976) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN MD49976) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2022-03-28 |