| NPI | 1124002142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: CT 038648) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CT 038648) |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2008-06-24 |