| NPI | 1023065109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: AZ 21645) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 21645) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2011-11-14 |