| NPI | 1972745388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MN 75992) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A120899) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CA A120899) | |
| Enumeration Date | 2009-03-31 |
| Last Update Date | 2024-08-18 |