| NPI | 1972846335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 55738) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 55738) |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2022-09-13 |