| NPI | 1538691092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MS 30460) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MS 30460) |
| 208000000X Pediatrics (Licence: AL MD.41039) | |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2023-08-18 |