| NPI | 1205818929 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: ME 017898)  | 
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CT 035451)  | 
| Enumeration Date | 2005-11-17 | 
| Last Update Date | 2022-09-09 |