| NPI | 1962443002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101236729) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101236729) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2022-04-29 |