| NPI | 1992779045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 76305) |
| Additional Taxonomies | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: MA 76305) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2007-07-08 |