| NPI | 1821256876 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MA 245750)  | 
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: IL 036-113999)  | 
| Enumeration Date | 2008-05-27 | 
| Last Update Date | 2010-11-01 |