| NPI | 1437475423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 52389) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CT 52389) |
| Enumeration Date | 2010-04-15 |
| Last Update Date | 2016-03-02 |