| NPI | 1134142177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: CO DR.0052221) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD071985L) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: PA MD071985L) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2026-06-15 |