| NPI | 1770661126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CO 49969) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX M4879) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NY 238275-1) | |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2011-08-11 |