| NPI | 1376508457 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: SD 8023) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 1553) |
| 208000000X Pediatrics (Licence: WI 50600) | |
| 208M00000X Hospitalist (Licence: WI 50600) | |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2013-03-19 |