| NPI | 1336161710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: VA 0101233212) |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2009-12-15 |