| NPI | 1205805678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MO 2011018389) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2011018389) |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2018-01-29 |