| NPI | 1083651822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: VA 0101237840) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101237840) |
| 207L00000X Anesthesiology (Licence: VA 0101237840) | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2010-02-10 |