| NPI | 1235201336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: VA 0101052317) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101052317) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2022-03-11 |