| NPI | 1548657653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OK 41124) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: AR E-11539) |
| Enumeration Date | 2015-04-16 |
| Last Update Date | 2023-10-10 |