| NPI | 1154359008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TN MD31774) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN MD31774) |
| 207P00000X Emergency Medicine (Licence: TN 0000031774) | |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2007-11-19 |