| NPI | 1306051206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: OH 35-091818) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 57 010803) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: PA MD437144) | |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2013-07-18 |