| NPI | 1205845914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: FL ME24020) |
| Additional Taxonomies | 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: FL 0024020) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2007-07-08 |