| NPI | 1699729384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: UT 6275131 1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO DR040345) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: CO DR040345) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: UT 6275131 8905) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2008-09-12 |