| NPI | 1932596913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: AL MD.38313) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: FL TRN21934) |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2021-03-03 |