| NPI | 1952807935 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: DC MD600003576) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: PA MD480657) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD480657) | |
| Enumeration Date | 2018-03-30 |
| Last Update Date | 2025-04-09 |