| NPI | 1134240104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: SC 23586) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC 23586) |
| 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: FL 99621) | |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2010-10-04 |