| NPI | 1033111810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: UT 5412561-1205) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: ID TL3586) |
| 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: UT 5412561-1205) | |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2017-06-22 |