| NPI | 1629090139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: PA MD041536L) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD041536L) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2013-04-16 |