| NPI | 1871648774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL 149434) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D56251) |
| 208000000X Pediatrics (Licence: MD D56251) | |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2023-03-14 |