| NPI | 1952340713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: WI 53279) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036-112685) |
| 207P00000X Emergency Medicine (Licence: WI 53279) | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2018-04-25 |