| NPI | 1902337447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MN 76557) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 303481) |
| 208000000X Pediatrics (Licence: MN 76557) | |
| Enumeration Date | 2017-03-26 |
| Last Update Date | 2024-04-17 |