| NPI | 1215101936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: HI MD-15927) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: UT 6195518-1205) |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2011-01-20 |