| NPI | 1447318928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX M5938) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX M5938) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2018-09-28 |