| NPI | 1902013659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TN MD0000044366) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN MD0000044366) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2022-03-22 |