| NPI | 1164472536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: CA G79591) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 226294) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MA 226294) | |
| 208000000X Pediatrics (Licence: CA G79591) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2014-07-04 |