| NPI | 1467436469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: KY 38540) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: KS 04-32974) |
| 208000000X Pediatrics (Licence: KS 04-32974) | |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2015-10-27 |