| NPI | 1760510572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MO 2010025681) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NC 2007-00110) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: KS 04-34544) | |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2011-09-01 |