| NPI | 1912979972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MN 45083) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 45083) |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2020-10-08 |