| NPI | 1306812466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: WA MD00032885) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD071712L) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2014-07-21 |