| NPI | 1427480359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: CO DR.0065306) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO DR.0065306) |
| 208000000X Pediatrics (Licence: VA 0101256950) | |
| Enumeration Date | 2013-08-02 |
| Last Update Date | 2020-12-07 |