| NPI | 1699727602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: ND 11287) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CO 26846) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2012-01-19 |