| NPI | 1083811657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: GA 069771) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: DC MD038634) |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2013-08-16 |