| NPI | 1770628083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 058992) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 235471) |
| 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: MA 235471) | |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2011-04-05 |