| NPI | 1710188941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: CA 20A14653) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 2039) |
| 208000000X Pediatrics (Licence: CA 20A14653) | |
| Enumeration Date | 2007-05-28 |
| Last Update Date | 2016-06-08 |