| NPI | 1235188020 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: VA 0101238046) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101238046) |
| 207L00000X Anesthesiology (Licence: VA 0101238046) | |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2009-12-07 |