| NPI | 1871817502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MO 2016011309) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2016011309) |
| Enumeration Date | 2010-03-24 |
| Last Update Date | 2021-01-15 |