| NPI | 1669682274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: PA MD442203) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 231175) |
| 208000000X Pediatrics (Licence: PA MD442203) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2013-04-10 |