| NPI | 1043367915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NC 2012-00810) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC TL30225) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2018-11-28 |