| NPI | 1942223797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: LA 301573) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR MD25403) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2017-04-04 |