| NPI | 1023099330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: PA MD440429) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD440429) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CT 031973) | |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2013-03-11 |