| NPI | 1982066296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: KY TP940) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2019-01088) |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2022-06-27 |