| NPI | 1730376518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: WA MD60216901) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: KS 04-47989) |
| Enumeration Date | 2007-09-26 |
| Last Update Date | 2023-09-22 |