| NPI | 1154516813 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 006207) | 
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CA 20A9877) | 
| 207L00000X Anesthesiology (Licence: OH 34-009889) | |
| 207P00000X Emergency Medicine (Licence: TX P6740) | |
| 208000000X Pediatrics (Licence: CA 20A9877) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: OH 34-009889) | |
| Enumeration Date | 2007-09-06 | 
| Last Update Date | 2025-09-16 |