| NPI | 1548316227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101258475) |
| Additional Taxonomies | 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: VA 0101258475) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2016-09-21 |