| NPI | 1558309898 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NV 14730) | 
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MO R8242) | 
| Enumeration Date | 2006-06-02 | 
| Last Update Date | 2013-07-01 |