| NPI | 1003870288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: GA 046445) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: UT 4928357-1205) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2024-01-30 |