| NPI | 1235328394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: CT 063293) |
| Additional Taxonomies | 207LC0200X Anesthesiology Critical Care Medicine (Licence: CT 036293) |
| Enumeration Date | 2007-10-15 |
| Last Update Date | 2007-10-15 |