| NPI | 1437410933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NH 17461) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 254066) |
| Enumeration Date | 2012-06-01 |
| Last Update Date | 2021-12-17 |