| NPI | 1346413606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: FL ME110705) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 243668) |
| 208000000X Pediatrics (Licence: FL ME110705) | |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2011-11-16 |