| NPI | 1962457549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: WA MD60122812) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD60122812) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2010-03-25 |