| NPI | 1912919424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NC 2013-02152) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2013-02152) |
| 208000000X Pediatrics (Licence: NC 2013-02152) | |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2024-07-15 |