| NPI | 1083732648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: CA a99004) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: TN 42854) |
| 208000000X Pediatrics (Licence: TX r5882) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TX r5882) | |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2021-11-29 |