| NPI | 1720258114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: LA MD.202980) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: LA MD.202980) |
| Enumeration Date | 2008-03-03 |
| Last Update Date | 2021-04-07 |