| NPI | 1982686549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MA 152593) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 152593) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2012-01-10 |