| NPI | 1033471859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301101049) |
| Additional Taxonomies | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: MI 4301101049) |
| Enumeration Date | 2012-06-08 |
| Last Update Date | 2019-07-10 |