| NPI | 1417995143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MD D66275) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301073223) |
| 208000000X Pediatrics (Licence: MD D66275) | |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2022-03-01 |