| NPI | 1871033589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: CA A146213) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A146213) |
| Enumeration Date | 2017-02-28 |
| Last Update Date | 2022-08-17 |