| NPI | 1770825168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: RI MD15330) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125-062857) |
| Enumeration Date | 2013-03-23 |
| Last Update Date | 2019-06-04 |