| NPI | 1942399217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: SC 27231) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL MD.28073) |
| 208000000X Pediatrics (Licence: SC 27231) | |
| 208000000X Pediatrics (Licence: AL MD.28073) | |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2019-07-01 |