| NPI | 1740434463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: PA MD443224) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD443224) |
| Enumeration Date | 2008-11-07 |
| Last Update Date | 2024-05-21 |