| NPI | 1346295524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 101755) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 101755) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2016-03-28 |