| NPI | 1265668131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: CO DR.0062009) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 266655-1) |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2019-08-26 |