| NPI | 1871120824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MO 2023010834) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: KS 94-11296) |
| 208000000X Pediatrics (Licence: MO 2023010834) | |
| 208000000X Pediatrics (Licence: KS 94-11296) | |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2025-12-02 |