| NPI | 1952336885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080T0002X Pediatrics, Medical Toxicology (Licence: AZ 48735) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 48735) |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: AZ 48735) | |
| 208000000X Pediatrics (Licence: AZ 48735) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2018-11-19 |