| NPI | 1760405120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NC 2006-00911) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2006-00911) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2010-05-12 |