| NPI | 1891180808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: CO DR.0066116) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2018012788) |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2021-09-22 |