| NPI | 1881738243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 282NC2000X General Acute Care Hospital, Children (Licence: NE 24206) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MN 47218) |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2011-03-15 |