| NPI | 1336132224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA G86401) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NV 11366) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NV 11366) | |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2018-08-02 |