| NPI | 1114156155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: VA 0102203091) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0102203091) |
| 208000000X Pediatrics (Licence: VA 0102203091) | |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2020-06-04 |