| NPI | 1104876663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: CO 63281) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: MO 108841) |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: KS 05-28654) | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2020-01-29 |