| NPI | 1841752946 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: AL MD.41801) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: AL MD.41801) | 
| Enumeration Date | 2019-04-05 | 
| Last Update Date | 2022-08-02 |