| NPI | 1417319336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: PA MT217667) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125068708) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2019-07-02 |