| NPI | 1306007489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: WI 52927) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125051613) |
| 208000000X Pediatrics (Licence: IN 01071170A) | |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2013-07-18 |