| NPI | 1184936239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: WA MD60537534) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT197721) |
| 208000000X Pediatrics (Licence: PA MT197721) | |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2018-10-15 |