| NPI | 1023279148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD442568) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101243146) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: VA 0101243146) | |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2017-03-21 |