| NPI | 1962930685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: FL 16710) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL 16710) |
| 208000000X Pediatrics (Licence: GA 9016) | |
| Enumeration Date | 2017-05-25 |
| Last Update Date | 2024-01-28 |