| NPI | 1093715682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: TN 21003) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TN 21003) |
| 208000000X Pediatrics (Licence: TN 21003) | |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2017-08-05 |