| NPI | 1144301938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OR MD162985) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: UT 341811-1205) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2017-03-01 |