| NPI | 1295962462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: FL OS12568) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: PA OS014712) |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2022-08-16 |