| NPI | 1447592910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: CO DR.0064050) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA ML60368595) |
| 208000000X Pediatrics (Licence: WA MD60644628) | |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2020-09-10 |