| NPI | 1326048760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SD 13433) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: TN 37699) |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NC 2009-00740) | |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2025-12-22 |