| NPI | 1194903054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MI 4301104025) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301104025) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: VA 0101250097) | |
| Enumeration Date | 2008-02-03 |
| Last Update Date | 2013-09-11 |