| NPI | 1952608580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NM RS2014-0568) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A120394) |
| Enumeration Date | 2011-02-16 |
| Last Update Date | 2016-12-15 |