| NPI | 1720176852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MD D71891) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL TRN10136) |
| 208000000X Pediatrics (Licence: MD D71891) | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2014-07-08 |