| NPI | 1306821368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 32297) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 32297) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: AZ 32297) | |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2023-07-31 |