| NPI | 1982999538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: PA OS017064) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA OS017064) |
| Enumeration Date | 2011-06-12 |
| Last Update Date | 2021-06-10 |