| NPI | 1770876583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: DC MD043066) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2014-00895) |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2015-06-15 |