| NPI | 1922036268 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: AR C5005) | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AR C5005) | 
| Enumeration Date | 2006-06-28 | 
| Last Update Date | 2008-05-21 |