| NPI | 1093866659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2013-02337) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NC 2013-02337) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2015-10-16 |