| NPI | 1932420122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: TX R6671) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036.132232) |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2018-07-26 |