| NPI | 1902035637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: CA A147108) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: DC MD040411) |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2018-07-03 |