| NPI | 1972842813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: VA 0101256699) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: UT 11330824-1205) |
| Enumeration Date | 2013-02-13 |
| Last Update Date | 2024-01-24 |