| NPI | 1417998600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: MD D0060175) |
| Additional Taxonomies | 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: DC MD34209) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2007-10-18 |