| NPI | 1912990870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MO 2021036054) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: IN 01098881A) |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2026-01-16 |