| NPI | 1871080804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CO DR.0077987) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NV 25705) |
| 208000000X Pediatrics (Licence: CO DR.0077987) | |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2026-09-01 |