| NPI | 1114212099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: PA MD450594) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT198952) |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: DE C10011479) | |
| Enumeration Date | 2011-06-18 |
| Last Update Date | 2017-02-28 |