| 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 |