| NPI | 1588156491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AZ R77062) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD61386971) |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2023-08-16 |