| NPI | 1124346390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2017-01066) |
| Additional Taxonomies | 207PP0204X Emergency Medicine Pediatric Emergency Medicine (Licence: NC 2017-01066) |
| Enumeration Date | 2010-05-12 |
| Last Update Date | 2018-03-17 |