| NPI | 1013181668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: ME MD20538) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 247146) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: PA MT202833) | |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2017-04-27 |