| NPI | 1922065267 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: DE C1-0012430)  | 
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NE 22177)  | 
| Enumeration Date | 2006-04-28 | 
| Last Update Date | 2018-03-17 |