| NPI | 1073003695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: OR MD223669) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: CO DR.0066577) |
| Enumeration Date | 2018-05-18 |
| Last Update Date | 2025-08-20 |