| NPI | 1528085115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME70075) |
| Additional Taxonomies | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: FL ME-70075) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2014-09-02 |