| NPI | 1063742328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: VA 0101258410) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX N5267) |
| 207L00000X Anesthesiology (Licence: VA 0101258410) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: DC 040772) | |
| 208000000X Pediatrics (Licence: PA MD429329) | |
| Enumeration Date | 2010-01-10 |
| Last Update Date | 2019-10-16 |