| NPI | 1194258384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MD D0093665) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ R76025) |
| 207P00000X Emergency Medicine (Licence: MD D0093665) | |
| Enumeration Date | 2017-04-05 |
| Last Update Date | 2023-11-09 |