| NPI | 1861811010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CA A172649) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: DC MD045205) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2021-06-09 |