| NPI | 1548403181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2012017779) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: MO 2012017779) |
| Enumeration Date | 2009-04-13 |
| Last Update Date | 2018-01-24 |