| NPI | 1760485346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: OH 208000000X) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.084463) |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2020-01-31 |