| NPI | 1497707913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: VA 0101040921) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101040921) |
| 207L00000X Anesthesiology (Licence: VA 0101040921) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2009-12-09 |