| NPI | 1952620809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: WI 69720) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT197708) |
| Enumeration Date | 2010-05-18 |
| Last Update Date | 2018-08-17 |