| NPI | 1174718035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: NJ 25MA08935900) |
| Additional Taxonomies | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: PA MD431091) |
| 208000000X Pediatrics (Licence: PA MD431091) | |
| 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: PA MD431091) | |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2011-08-18 |