| NPI | 1568666154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: WI 63769) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX BP1-0026594) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2015-10-07 |