| NPI | 1134567415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: CO CDR.0002231) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA MD-47193) |
| 207P00000X Emergency Medicine (Licence: AZ R73951) | |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: IA MD-47193) | |
| 207PT0002X Emergency Medicine, Medical Toxicology (Licence: IA MD-47193) | |
| 207PT0002X Emergency Medicine, Medical Toxicology (Licence: TX U5897) | |
| 208000000X Pediatrics (Licence: AZ R73951) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TX U5897) | |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2024-08-01 |