| NPI | 1184880148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM MD2008-0373) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NM MD2008-0373) |
| Enumeration Date | 2008-07-30 |
| Last Update Date | 2008-07-30 |