| NPI | 1548404924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: PA MD458345) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD458345) |
| Enumeration Date | 2009-04-29 |
| Last Update Date | 2016-08-02 |