| NPI | 1912392747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080H0002X (Licence: NY 287275) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 287275) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NY 287275) | |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2024-02-29 |