| NPI | 1093135725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ R74480) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ R74480) |
| Enumeration Date | 2014-04-21 |
| Last Update Date | 2020-06-02 |