| NPI | 1134175847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 108808) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 108808) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2007-07-16 |