| NPI | 1386605483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 35129661) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TX L6795) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MN 55858) | |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2022-02-01 |