| NPI | 1912291402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: MN 62044) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 62044) |
| Enumeration Date | 2011-06-02 |
| Last Update Date | 2020-04-16 |