| NPI | 1851454623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 19587) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 19587) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2013-08-20 |