| NPI | 1912177742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: LA MD.204215) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA MD.204215) |
| Enumeration Date | 2008-03-07 |
| Last Update Date | 2016-09-26 |