| NPI | 1851503478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: HI MD-15441) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX M6337) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2010-10-26 |