| NPI | 1154516813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P6740) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 34-009889) |
| 207P00000X Emergency Medicine (Licence: AZ 006207) | |
| 208000000X Pediatrics (Licence: CA 20A9877) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CA 20A9877) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: OH 34-009889) | |
| Enumeration Date | 2007-09-06 |
| Last Update Date | 2023-08-01 |