| NPI | 1992936413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: AK 100605) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 53081) |
| 208000000X Pediatrics (Licence: NC 2014-01489) | |
| Enumeration Date | 2009-07-31 |
| Last Update Date | 2015-08-06 |