| NPI | 1750303525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: LA 202244) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA 5E799) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2010-06-08 |