| NPI | 1821215583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MD D74146) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: RI LP00853) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2022-06-22 |