| NPI | 1932168762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ACN530) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: PR 9694) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: FL ACN530) | |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2020-11-11 |