| NPI | 1114103199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: PA MD433789) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A98759) |
| 208000000X Pediatrics (Licence: PA MD433789) | |
| Enumeration Date | 2008-01-21 |
| Last Update Date | 2016-05-17 |