| NPI | 1982281432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: CO DR.0075012) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO DR.0075012) |
| 208000000X Pediatrics (Licence: PA MD485162) | |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2025-09-02 |