| NPI | 1649481045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MN 55904) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 238646) |
| 208000000X Pediatrics (Licence: MA 238646) | |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2018-04-11 |