| NPI | 1265429419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AL MD.15386) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL MD.15386) |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2011-01-18 |