| NPI | 1487641635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: AL MD.19725) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL MD.19725) |
| 208000000X Pediatrics (Licence: AL MD.19725) | |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2019-07-10 |