| NPI | 1235574781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MA 282515) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD463876) |
| 208000000X Pediatrics (Licence: MI 4301102738) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: PA MT212545) | |
| Enumeration Date | 2013-05-09 |
| Last Update Date | 2021-07-12 |