| NPI | 1710021266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: AL 32466) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: FL ME 113837) |
| 208000000X Pediatrics (Licence: FL ME 113837) | |
| Enumeration Date | 2007-02-17 |
| Last Update Date | 2015-05-13 |