| NPI | 1679531446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MI 4301101921) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TN 21071) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: WI 49745) | |
| 208000000X Pediatrics (Licence: MI 4301101921) | |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2012-12-04 |