| NPI | 1215193503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: AZ 44583) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 44583) |
| Enumeration Date | 2008-08-06 |
| Last Update Date | 2018-01-17 |