| NPI | 1194894733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: VA 0101035944) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101035944) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2013-08-07 |