| NPI | 1982611604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 010134006) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 010134006) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2012-09-12 |