| NPI | 1316430499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: CA A195631) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA ML60954039) |
| 208000000X Pediatrics (Licence: CA A195631) | |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2024-07-22 |