| NPI | 1245364009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: PA MD462941) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 199175) |
| 208000000X Pediatrics (Licence: PA MD462941) | |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2024-05-21 |