| NPI | 1184688772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: ND 11335) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: WA MD00031504) |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2012-04-27 |