| NPI | 1831546928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NV 26926) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301115442) |
| Enumeration Date | 2016-05-18 |
| Last Update Date | 2025-04-25 |