| NPI | 1235286030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: GA 058455) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NV 13017) |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: MI 4301055324) | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2010-12-08 |