| NPI | 1245750850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: AZ 63380) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125-071221) |
| Enumeration Date | 2017-06-23 |
| Last Update Date | 2024-08-23 |