| NPI | 1215249362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TX P6514) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX P6514) |
| 208000000X Pediatrics (Licence: GU MTL-2018-009) | |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2024-06-06 |