| NPI | 1669605283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NV 14963) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME 104424) |
| 208000000X Pediatrics (Licence: FL ME104424) | |
| Enumeration Date | 2009-08-30 |
| Last Update Date | 2013-10-09 |