| NPI | 1548360498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: OH 35138160) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NJ MA64974) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2020-01-15 |