| NPI | 1275837114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: DC MD041251) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MD D77127) |
| Enumeration Date | 2011-01-07 |
| Last Update Date | 2017-10-09 |