| NPI | 1073584967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MA 79828) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 79828) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2020-03-09 |