| NPI | 1992783534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MI 4301038539) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI 4301038539) |
| 208000000X Pediatrics (Licence: MI 4301038539) | |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2017-11-20 |