| NPI | 1053337543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TX N5264) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 39632) |
| 208000000X Pediatrics (Licence: GA 040490) | |
| 207P00000X Emergency Medicine (Licence: GA 040490) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: GA 040490) | |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2022-12-05 |