| NPI | 1629093760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AZ 28241) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: PA MD479996) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2025-01-03 |