| NPI | 1669451373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA 23540) |
| Additional Taxonomies | 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: WA 23540) |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2023-09-22 |