| NPI | 1174847255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: AZ 005447) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CA 20A9613) |
| Enumeration Date | 2010-03-18 |
| Last Update Date | 2013-05-29 |