| NPI | 1871538975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: AZ 41511) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MD D47052) |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2018-02-08 |