| NPI | 1063032068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: IN 01093140A) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME161547) |
| Enumeration Date | 2020-04-20 |
| Last Update Date | 2025-03-08 |