| NPI | 1346362720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A55580) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA 46561) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CA A55580) | |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2015-07-15 |