| NPI | 1811526387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: VA 0102207821) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0102207821) |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2026-01-19 |