| NPI | 1497807044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: ID M-11365) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 49001) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: WI 49001) | |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2016-09-23 |