| NPI | 1508039488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: PA MD449123) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2007018783) |
| Enumeration Date | 2008-04-10 |
| Last Update Date | 2013-11-06 |