| NPI | 1124115035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: LA MD014137) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA MD014137) |
| 208000000X Pediatrics (Licence: LA MD014137) | |
| 208000000X Pediatrics (Licence: TN MD13396) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TN MD13396) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2021-01-12 |