| NPI | 1699791905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: AZ 43810) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MO 200501140) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MO 200501140) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2018-03-23 |