| NPI | 1548345283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD00048997) |
| Additional Taxonomies | 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: CO 39447) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2020-10-09 |