| NPI | 1699743682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MA 160891) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 160891) |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2015-09-10 |