| NPI | 1134347669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: CO DR.0059782) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NH 14674) |
| 208000000X Pediatrics (Licence: GA 65996) | |
| 208000000X Pediatrics (Licence: TX N4944) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: CO DR.0059782) | |
| Enumeration Date | 2007-04-22 |
| Last Update Date | 2022-10-30 |