| NPI | 1942663737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: VA 1942663737) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 1942663737) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: VA 1942663737) | |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2020-05-29 |