| NPI | 1144259920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TN MD22161) |
| Additional Taxonomies | 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: TN MD22161) |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2018-11-08 |