| NPI | 1306824222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CO 41794) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO 41794) |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2026-03-28 |