| NPI | 1871882993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: WI 61976) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 61976-20) |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: WI 61976) | |
| 208000000X Pediatrics (Licence: WI 61976) | |
| Enumeration Date | 2011-03-29 |
| Last Update Date | 2021-01-26 |