| NPI | 1316992332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: CO DR.0069523) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35080876) |
| 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: OH 35080876) | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2022-12-21 |