| NPI | 1285629923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: CA G157727) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: AL 00020602) |
| 207P00000X Emergency Medicine (Licence: AL 00020602) | |
| 208000000X Pediatrics (Licence: NV 15576) | |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NV 15576) | |
| 208000000X Pediatrics (Licence: CA G157727) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MN 75935) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: VA 0101264310) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NC 9900314) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: PA MD486821C) | |
| Enumeration Date | 2005-09-19 |
| Last Update Date | 2025-08-26 |