| NPI | 1801670872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: CO DR.0077232) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO DR.0077232) |
| Enumeration Date | 2023-08-22 |
| Last Update Date | 2026-08-06 |