| NPI | 1437134681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AZ 68756) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 0436303) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: KS 0436303) | |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2023-09-01 |