| NPI | 1295762375 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: GA 076507)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 076507)  | 
| Enumeration Date | 2006-06-26 | 
| Last Update Date | 2020-09-02 |