| NPI | 1952480162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NC 34818) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 34818) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: LA 09725) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: GA 045166) | |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2012-01-30 |