| NPI | 1144617291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 35145583) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A132166) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: WA MD61071894) | |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2022-06-01 |