| NPI | 1134487515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AL MD.32944) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL MD.32944) |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2016-08-12 |