| NPI | 1801844931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: NC 9400073) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 9400073) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2015-07-15 |