| NPI | 1962471060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: FL ME61274) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME61274) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2009-04-27 |