| NPI | 1386634673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: FL ME75965) |
| Additional Taxonomies | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: KS 04-29988) |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2009-07-22 |