| NPI | 1669791620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: SC 87827) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NC 2013-00824) |
| 208000000X Pediatrics (Licence: PA OT013567) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TX Q8506) | |
| Enumeration Date | 2010-05-28 |
| Last Update Date | 2023-07-14 |