| NPI | 1972553089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: PA MD041980L) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: IN 01077658A) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2016-10-12 |