| NPI | 1669649042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: MO 2014020142) |
| Additional Taxonomies | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: TX N3647) |
| 208000000X Pediatrics (Licence: TX N3647) | |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2014-08-04 |