| NPI | 1336149558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TN 25708) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: TN 25708) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2017-03-21 |