| NPI | 1235210022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: CA C149126) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: UT 4757219-1205) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2022-07-21 |