| NPI | 1043259351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 105280) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: MO 105280) |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: MO 105280) | |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2015-10-14 |