| NPI | 1871558106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: FL ME107348) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 200501360) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2010-10-01 |