| NPI | 1942294897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: FL ME141033) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036-096515) |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2023-02-03 |