| NPI | 1851590160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX BP20036920) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AL MD.28711) |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2012-07-19 |