| NPI | 1881762391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TN 50515) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 50515) |
| 208000000X Pediatrics (Licence: VA 101058204) | |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2023-03-07 |