| NPI | 1356340756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: LA 15211R) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA 15211R) |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2022-06-28 |