| NPI | 1063485779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: GA 74590) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA C54631) |
| 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: CA C54631) | |
| Enumeration Date | 2006-02-12 |
| Last Update Date | 2017-04-24 |