| NPI | 1588899546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: WA OP60517574) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA R-8582) |
| Enumeration Date | 2009-05-20 |
| Last Update Date | 2015-05-06 |