| NPI | 1558469734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: LA MD.16379) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA 16379) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: LA 16379) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2011-05-10 |