| NPI | 1992912166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: KY 44404) |
| Additional Taxonomies | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: HI 15615) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2012-09-28 |