| NPI | 1295908705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: GA 062235) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101243233) |
| 208000000X Pediatrics (Licence: GA 062235) | |
| Enumeration Date | 2008-04-04 |
| Last Update Date | 2013-12-03 |