| NPI | 1043246879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TN MD30444) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN MD30444) |
| 207P00000X Emergency Medicine (Licence: TN 30444) | |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2015-05-08 |