| NPI | 1548766116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD480019) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D95565) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MI 4301514360) | |
| 208000000X Pediatrics (Licence: DC MD049178) | |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2025-07-04 |