| NPI | 1265550602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA C163504) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: FL ME96696) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NJ 25MA08146800) | |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2022-04-26 |