| NPI | 1134148588 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: DC MD036676) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036-114606) | 
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MD D0067848) | |
| Enumeration Date | 2006-07-18 | 
| Last Update Date | 2013-12-30 |