| NPI | 1548285174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: KY 36113) |
| Additional Taxonomies | 2080H0002X Pediatrics, Hospice and Palliative Medicine (Licence: KY 36113) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2014-07-16 |