| NPI | 1083713655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: CA G80706) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA G80706) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TX R6708) | |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2024-05-09 |