| NPI | 1386797595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: FL ME108180) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NJ 25MAO7541100) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2015-07-20 |