| NPI | 1699411074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: AZ 011770) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 011770) |
| Enumeration Date | 2022-05-09 |
| Last Update Date | 2025-09-24 |