| NPI | 1215906607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: NC 2008-00312) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D0060461) |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2009-01-22 |