| NPI | 1821026964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: FL ME48213) |
| Additional Taxonomies | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: NM 2011-0187) |
| 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: AZ 46319) | |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2013-09-11 |