| NPI | 1487768735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TN MD23546) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 23546) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2013-01-16 |