| NPI | 1114213451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: IA MD-47856) |
| Additional Taxonomies | 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: MO 2014008797) |
| 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: KS 04-40003) | |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2020-10-05 |