| NPI | 1053581876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MN 55410) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: PA MT196230) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: PA MD441915) | |
| Enumeration Date | 2008-03-07 |
| Last Update Date | 2016-01-22 |